Objective:To explore the clinical efficacy of staged reconstruction with anterolateral thigh flap (ALTF) for wrist-forearm soft tissue defects of electrical burns.Methods:A retrospective observational study was conducted on 10 patients who had wrist-forearm soft tissue defects after electrical burns and were admitted in the Department of Burns, Zhengzhou First People's Hospital from January 2019 to December 2022. The patients were 6 males and 4 females, aged 8 to 64 years. All the patients were third-and-fourth degree electrical burns. Debridement was performed to remove the necrotic tissues around the wound in stage I surgery. Area of the wound after debridement ranged from 15 cm×11 cm to 31 cm×20 cm. According to the condition of wrist-forearm injury, the wounds with relatively mild injury were retained. Free ALTF was used to cover the wound surface. Size of the flaps ranged from 16 cm×12 cm to 32 cm×21 cm. The descending branch of lateral circumflex femoral artery and the accompanying veins carried by the flap were anastomosed end-to-end with the radial artery and vein or ulnar artery and vein in the recipient site, respectively. Conditions of other vessels were explored. The great saphenous veins in a length of 10-18 cm was used to bridge the occluded arteries. The donor sites were covered by medium thick skin grafts from trunk. After survival of the flap, stage Ⅱ surgery was carried out to debride the wound temporarily retained in stage I surgery and to thin the flap, then had all the wound covered with the thinned flap. Follow-ups were conducted at outpatient clinic, and via telephone and WeChat interviews. The limb salvage, flap survival, vascular compromise and other complications, as well as the donor site healing were observed. The wound coverage rate of the thinned flap. The appearance of flap, donor site scar hyperplasia, the patient satisfaction with the shape and function of the donor site at 6 months after the stage Ⅱ surgery were evaluated. Likert scale was employed to evaluate the patient satisfaction. The Michigan Hand Outcomes Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH) were used to evaluate the upper limb function in daily life of the patients.Results:The limb salvages in the 10 patients were all successful, and the flaps survived without any postoperative event of vascular compromise or other complication. One patient had mild cyanosis at the edges of flap after surgery and regressed at 7 days later. One flap had poor blood circulation and partial necrosis. The thinned flaps covered the wound completely after the stage-Ⅱ flap thinning surgery. The postoperative follow-up period was 6.0-7.0 months. All skin grafts in the donor sites survived well. The thinned flaps of stage Ⅱ surgery achieved 100% in wound coverage rate. At 6 months after surgery, the colour and texture of the flaps were about the same as those of the normal skin of the upper limb. There were linear scars in both of donor and recipient sites. Four patients were satisfactory to the postoperative appearance and function of the donor site and 6 patients were very satisfactory. MHQ scores were 49-82 (mean, 74) points; DASH scores were 27-45 (mean, 32) points.Conclusion:Reconstruction of the wounds in wrist-forearm soft tissue defects of electrical burns with ALTF in staged surgery, can improve the function and aesthetics of the wrist-forearm. It is a good method.

BACKGROUND:Large deep burn wounds are often accompanied by scar hyperplasia after healing,requiring transplantation of medium-thickness skin for repair,and the medium-thickness skin slices taken generally reach below the papillary layer of the dermis.If not handled correctly,complications such as delayed healing,ulceration,and post-healing pain and itching in the donor area can easily occur.Therefore,the repair of wounds in the donor area should be emphasized.OBJECTIVE:To observe the safety and practicability of autologous scalp repair of skin donor area in patients with deep burns and scarring.METHODS:Sixty patients with deep burn and scar hyperplasia admitted to the Burn Department of Zhengzhou First People's Hospital from January 2021 to September 2023 were selected as the study subjects.They all needed medium-thickness skin transplantation and repair,and were divided into study group(n=30)and control group(n=30)according to random systematic sampling method.The skin was taken from the patient's own medium-thickness skin on the leg or back.In the study group,the skin donor area was repaired with self-blade thick scalp replantation,and in the control group,the skin donor area was repaired with absorbent dressing.The wound healing rate and the time to complete epithelialization of the wound were observed and compared in the two groups 6 days after surgery.The pain of dressing change at 3 and 6 days after surgery and scar hyperplasia in the skin donor area at 6 months after surgery were compared between two groups.RESULTS AND CONCLUSION:Compared with the control group,the time to complete epithelialization of the wound was significantly lower in the study group(P<0.05),and the wound healing rate was significantly higher in the study group(P<0.05),the pain score for dressing change at 3 and 6 days after surgery was significantly lower in the study group(P<0.05),and the scar hyperplasia rate,scar score and itch score were also significantly lower in the study group(P<0.05)at 6 months after surgery.In conclusion,autologous scalp repair of the medium-thickness skin donor area can accelerate wound healing and reduce scar hyperplasia.

Objective:To explore the clinical efficacy of staged reconstruction with anterolateral thigh flap (ALTF) for wrist-forearm soft tissue defects of electrical burns.Methods:A retrospective observational study was conducted on 10 patients who had wrist-forearm soft tissue defects after electrical burns and were admitted in the Department of Burns, Zhengzhou First People's Hospital from January 2019 to December 2022. The patients were 6 males and 4 females, aged 8 to 64 years. All the patients were third-and-fourth degree electrical burns. Debridement was performed to remove the necrotic tissues around the wound in stage I surgery. Area of the wound after debridement ranged from 15 cm×11 cm to 31 cm×20 cm. According to the condition of wrist-forearm injury, the wounds with relatively mild injury were retained. Free ALTF was used to cover the wound surface. Size of the flaps ranged from 16 cm×12 cm to 32 cm×21 cm. The descending branch of lateral circumflex femoral artery and the accompanying veins carried by the flap were anastomosed end-to-end with the radial artery and vein or ulnar artery and vein in the recipient site, respectively. Conditions of other vessels were explored. The great saphenous veins in a length of 10-18 cm was used to bridge the occluded arteries. The donor sites were covered by medium thick skin grafts from trunk. After survival of the flap, stage Ⅱ surgery was carried out to debride the wound temporarily retained in stage I surgery and to thin the flap, then had all the wound covered with the thinned flap. Follow-ups were conducted at outpatient clinic, and via telephone and WeChat interviews. The limb salvage, flap survival, vascular compromise and other complications, as well as the donor site healing were observed. The wound coverage rate of the thinned flap. The appearance of flap, donor site scar hyperplasia, the patient satisfaction with the shape and function of the donor site at 6 months after the stage Ⅱ surgery were evaluated. Likert scale was employed to evaluate the patient satisfaction. The Michigan Hand Outcomes Questionnaire (MHQ) and Disabilities of the Arm, Shoulder and Hand (DASH) were used to evaluate the upper limb function in daily life of the patients.Results:The limb salvages in the 10 patients were all successful, and the flaps survived without any postoperative event of vascular compromise or other complication. One patient had mild cyanosis at the edges of flap after surgery and regressed at 7 days later. One flap had poor blood circulation and partial necrosis. The thinned flaps covered the wound completely after the stage-Ⅱ flap thinning surgery. The postoperative follow-up period was 6.0-7.0 months. All skin grafts in the donor sites survived well. The thinned flaps of stage Ⅱ surgery achieved 100% in wound coverage rate. At 6 months after surgery, the colour and texture of the flaps were about the same as those of the normal skin of the upper limb. There were linear scars in both of donor and recipient sites. Four patients were satisfactory to the postoperative appearance and function of the donor site and 6 patients were very satisfactory. MHQ scores were 49-82 (mean, 74) points; DASH scores were 27-45 (mean, 32) points.Conclusion:Reconstruction of the wounds in wrist-forearm soft tissue defects of electrical burns with ALTF in staged surgery, can improve the function and aesthetics of the wrist-forearm. It is a good method.

BACKGROUND:Large deep burn wounds are often accompanied by scar hyperplasia after healing,requiring transplantation of medium-thickness skin for repair,and the medium-thickness skin slices taken generally reach below the papillary layer of the dermis.If not handled correctly,complications such as delayed healing,ulceration,and post-healing pain and itching in the donor area can easily occur.Therefore,the repair of wounds in the donor area should be emphasized.OBJECTIVE:To observe the safety and practicability of autologous scalp repair of skin donor area in patients with deep burns and scarring.METHODS:Sixty patients with deep burn and scar hyperplasia admitted to the Burn Department of Zhengzhou First People's Hospital from January 2021 to September 2023 were selected as the study subjects.They all needed medium-thickness skin transplantation and repair,and were divided into study group(n=30)and control group(n=30)according to random systematic sampling method.The skin was taken from the patient's own medium-thickness skin on the leg or back.In the study group,the skin donor area was repaired with self-blade thick scalp replantation,and in the control group,the skin donor area was repaired with absorbent dressing.The wound healing rate and the time to complete epithelialization of the wound were observed and compared in the two groups 6 days after surgery.The pain of dressing change at 3 and 6 days after surgery and scar hyperplasia in the skin donor area at 6 months after surgery were compared between two groups.RESULTS AND CONCLUSION:Compared with the control group,the time to complete epithelialization of the wound was significantly lower in the study group(P<0.05),and the wound healing rate was significantly higher in the study group(P<0.05),the pain score for dressing change at 3 and 6 days after surgery was significantly lower in the study group(P<0.05),and the scar hyperplasia rate,scar score and itch score were also significantly lower in the study group(P<0.05)at 6 months after surgery.In conclusion,autologous scalp repair of the medium-thickness skin donor area can accelerate wound healing and reduce scar hyperplasia.

Aurora kinase A (Aurora-A), a serine/threonine kinase, plays a pivotal role in various cellular processes, including mitotic entry, centrosome maturation and spindle formation. Overexpression or gene-amplification/mutation of Aurora-A kinase occurs in different types of cancer, including lung cancer, colorectal cancer, and breast cancer. Alteration of Aurora-A impacts multiple cancer hallmarks, especially, immortalization, energy metabolism, immune escape and cell death resistance which are involved in cancer progression and resistance. This review highlights the most recent advances in the oncogenic roles and related multiple cancer hallmarks of Aurora-A kinase-driving cancer therapy resistance, including chemoresistance (taxanes, cisplatin, cyclophosphamide), targeted therapy resistance (osimertinib, imatinib, sorafenib, etc.), endocrine therapy resistance (tamoxifen, fulvestrant) and radioresistance. Specifically, the mechanisms of Aurora-A kinase promote acquired resistance through modulating DNA damage repair, feedback activation bypass pathways, resistance to apoptosis, necroptosis and autophagy, metastasis, and stemness. Noticeably, our review also summarizes the promising synthetic lethality strategy for Aurora-A inhibitors in RB1, ARID1A and MYC gene mutation tumors, and potential synergistic strategy for mTOR, PAK1, MDM2, MEK inhibitors or PD-L1 antibodies combined with targeting Aurora-A kinase. In addition, we discuss the design and development of the novel class of Aurora-A inhibitors in precision medicine for cancer treatment.

Objective:To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy.Methods:This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0–1; and (7) ASA score I–III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores).Result:[1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10–1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4–13) days. The median time to postoperative oral intake was 7 (range, 2–14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3–18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457).Conclusion:Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.

Objective:To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy.Methods:This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0–1; and (7) ASA score I–III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores).Result:[1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10–1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4–13) days. The median time to postoperative oral intake was 7 (range, 2–14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3–18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457).Conclusion:Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.

Objective:To discuss the long-term survival and risk factors of thyroid cancer in the real world in China.Methods:The clinical data of thyroid cancer patients who underwent initial surgery from Apr. 1998 to Dec. 2018 were retrospectively analyzed, including patients’sex, age, surgical records, pathology, hospitalization records and follow-up. According to the prognosis, the patients were divided into disease-free survival group and recurrence/metastasis/death group. Univariate analysis and multivariate regression analysis were conducted to analyze the risk factors affecting the prognosis of thyroid cancer. The clinical features and prognostic risk factors of thyroid cancer patients were investigated.Results:A total of 2038 cases were collected, and the longest follow-up time was more than 20 years. A total of 1876 cases were included in the study, 162 cases were lost, and the rate of follow-up was 7.9%. Among them, 1858 survived, the overall survival rate was 99.04%; 18 died, and the overall mortality rate was 0.96%. According to the prognosis of thyroid cancer, the patients were divided into 2 groups, including 1808 cases in the disease-free survival group and 68 cases in the relapsed-metastatic-death group. The study found that there were statistical differences between the two groups in terms of patients’age [ (45.40±11.016) vs (51.53±15.199, P=0.000) , the male ratio (32.854%, 48.529%, P=0.001) , whether tumor breaks through capsule (20.077%, 33.823%, P=0.006) , central lymph node metastasis (48.834%, 70.588%, P=0.001) and lateral lymph node metastasis (31.084%, 55.882%, P=0.000) , and there was no difference between the number of tumor lesions. Conclusion:Thyroid cancer has a good prognosis, but according to the characteristics of patients with thyroid cancer in my country, it should still be treated early in the clinic, and the standardization and thoroughness of surgery should be adhered to during the treatment.

Objective:To analyze the incidence of HIV infection and identify associated risk factors in drug abusers among men who have sex with men (MSM) in Tianjin and Shanghai through a cohort study and provide a basis for HIV prevention in this population.Methods:A prospective cohort study was conducted among MSM who had a history of drug abuse in the past six months from June 2016 to June 2018 in the two cities. MSM were investigated to obtain information on sociodemographic characteristics, HIV-related sexual behaviors, and drug abuse. Follow-up investigation and HIV testing were carried out based on the baseline survey and testing. Cox regression analysis was conducted to identify the risk factors for HIV infection.Results:There were 455 eligible subjects, and 16 new HIV infection cases were identified in the 2-year follow-up survey. The cumulative follow-up time was 586.08 person-years, and the incidence of HIV infection was 2.73/100 person-years. The multivariate Cox regression analysis results showed that compared with those aged ≥25 years, consistent condom use during anal sex with men in the past six months, without mixed-use of drugs, these aged <25 years ( HR=5.01, 95% CI: 1.09-23.11), inconsistent condom use during anal sex with men in the past six months ( HR=1.58, 95% CI: 1.04-2.41) and mixed-use of drugs ( HR=1.92, 95% CI: 1.08-3.40) were significantly associated with HIV infection in this cohort. Conclusions:The younger age, inconsistent condom use during anal sex with men, and mixed drug use appeared as risk factors of new HIV infection in drug abusers among MSM. HIV prevention and intervention in this population should be further strengthened.

Objective To detect the influence of the first operation standardized or not on reoperation for differentiated thyroid carcinoma.Methods Retrospective analysis was conducted of the clinical data of 217 reoperation case of differentiated thyroid carcinoma from May 2009 to March 2018 in the 960th Hospital of the PLA Joint Logistic Support Force,including 58 male cases and 159 female cases,with the average age of 46.65 years (range from 19 to 76).According to the first operation standardized or not,all patientswas divided into standardized group (n =114) and non-standard group (n =103).Between the two groups,the number of dissected and metastatic lymph nodes,tumor pathology,recurrence range of glandular and central lymph nodes,number of lymph nodes removed and transferred,operation and drainage time,tumor invaded surrounding tissues,invasion sites,and complications were conducted.Results The overall gland recurrence rate was 20.2％ of 217 cases (44/217),8.8％ (10/114) in the standardized group and 33％ (34/103)in the non-standard group.The central group had a total recurrence rate of 38.7％ (84/217),and the standardized group and non-standard group were 22.8％ (26/114) and 56.3 ％ (58/103),respectively.For patients,the total cervical lymph node recurrence rate was 74.7％ (162/217),and the standardized group and non-standard group were 87.7％ (100/114),and 60.3％ (62/103),respectively.All of the difference was statistically significant(P =0.000,P =0.000,P =0.000).The operation time and drainage time of the standardized surgery group were significantly shorter than the non-standard group[(2.52±0.80)h vs(3.14±0.83) h,P=0.000;(4.37±1.28)d vs (5.16±1.41)d,P=0.000].Conclusions For differentiated thyroid carcinoma,the nonstandard treatment significantly affected the tumor residual rate in gland and lymph node metastasis rate of reoperation,andstandardized surgical treatmentshould be advocated.